Theo Herbert Powell, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD11637 Issued in OR

Practice address

495 SW Ramsey Ave
Grants Pass, OR 97527

Phone

(541) 476-6644

Fax

(541) 472-5673

NPI assigned

Jun 17, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

Loma Linda University School of Medicine, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grants Pass Clinic LLPGroup PAC ID 9234123977, 16 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: theopowell@grantspass.allscriptsdirect.net
• Direct secure messaging: theopowell@gpc.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Grants Pass Clinic LLP

  • Internal Medicine Physician
  • Grants Pass, OR
  • NPI 1760418032

  Surgery

  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164427951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 SW RAMSEY AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "97527",
            "telephone_number": "541-476-6644",
            "fax_number": "541-472-5673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 SW RAMSEY AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "97527",
            "telephone_number": "541-476-6644",
            "fax_number": "541-472-5673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "THEO",
        "middle_name": "HERBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD11637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "074527",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tamilyn Potts
• Jade Poulain
• Sara J Pourchot, SLP
• Jane Powell, MA; LPC; NCC
• Tamara Powell, M.D.
• William Carrington Powell Jr., LCSW
• Practical Psychiatry LLC
• Megan Ilene Pratt, CPM,LDM
• Precise Touch Physical Therapy LP
• Pregnancy Care Center of Grants Pass

• Surgery Physician in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Surgery Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.